When it comes to prostate health and prostate cancer, there are all sorts of terms, tests and scores that patients and their loved ones need to understand.
Two of the most common are the Gleason and the PSA score. And the experts at the CyberKnife Center of Miami – a premier and the leading cancer radiation treatment center in South Florida – want you to understand what these scores mean and how they can impact your care if you are diagnosed with prostate cancer.
Let’s start with the basics before we take a deeper dive.
The PSA or prostate-specific antigen blood score is a snapshot of a man’s overall prostate health. It’s a test done with a simple blood draw.
The Gleason score is a grading scale used to determine how aggressive a prostate cancer is and what may be the best treatment option, according to the Prostate Cancer Education Council. It’s assigned after a man is diagnosed with prostate cancer and has a biopsy to take a closer look at the cancer. In other words, your biopsy will determine your Gleason score.
Now, onto a deeper discussion.
PSA Numbers Explained
According to Prostate Cancer Research, PSA levels are age dependent. So, a normal PSA level for a man in his forties is lower than a man in his seventies.
- For men between 50 and 59 a normal range is up to 3 ng/ml.
- For men 60-69 normal is up to 4 ng/ml.
- For men 70-79 normal is up to 5 ng/ml.
However, if your PSA levels are elevated, that does not mean you have prostate cancer. Three out of four men with higher-than-normal PSA levels don’t have cancer. The increased level is likely due to other prostate issues such as prostatitis or a urinary infection. However, if you’re levels are rising, talk to your doctor about additional screening. And remember, a PSA level can also miss prostate cancer. PSA testing misses one in seven cases.
PSA Levels Pre-and-Post-Cancer Treatment
If you are diagnosed with prostate cancer, PSA levels take on different meanings during and after treatment.
PSA levels monitor how effective the treatment is and detect any recurrence. However, the American Cancer Society says PSA levels can fluctuate, meaning they are only one indicator of what’s happening inside your body.
For men who opt for surgery to remove the prostate, PSA levels should drop to low or even undetectable levels a few months after treatment. A rising PSA after that point can indicate recurrence. That’s why monitoring is important.
For men who opt for radiation to treat their cancer, PSA levels tend to drop slowly after treatment and may not plateau to their lowest levels until two years post treatment. But the normal cells in the prostate will continue to make some PSA.
With radiation patients, doctors look for trends in PSA levels after treatment. A one-time rise may not mean the cancer is still there or it has recurred. But repeated testing indicating a rise in levels could be concerning. Doctors also watch for those PSA doubling times. The faster the doubling time, generally the more cause for concern.
There can also be what’s called a PSA bounce with external beam radiation. In these cases, the PSA levels rise for the first few years after treatment, then go back down. Doctors don’t know why this phenomenon occurs.
Gleason Score Explained
The Gleason score was developed by pathologist Dr. Donald Gleason in the 1960s because he discovered that cancerous cells fall into five different distinct patterns as they morph from normal to malignant cells. So, cells were originally graded from 1 to 5. Cells graded at 1 are the most normal whereas cells graded at 5 are typically considered high grade – meaning they’ve changed the most. However, since the original classification, 1 and 2 are no longer used. Only 3, 4 and 5 are assigned, and they are assigned twice.
Gleason Score Grade One
The pathologist reviewing a patient’s biopsy will give a number from 3 to 5 on the most predominant pattern in the biopsy.
Gleason Score Grade Two
Then the pathologist will assign a number from 3 to 5 on the second most predominant pattern in a biopsy.
Gleason Score Added
Finally, the two numbers are added.
For example, if the first number is a 5 and the second is a 4, the score is 9. The scores will range from 6 to 10, with 6 being the lowest grade cancer.
Prostate Cancer Grade Groups
Here’s where it gets a bit tricky. According to the Prostate Cancer Foundation, in 2014, the International Society of Urological Pathology placed the Gleason scores into grade groups.
- A score of 6 fall into Grade Group 1 – the least aggressive group
- 3+4 falls into Grade Group 2
- 4+3 falls into Grade Group 3
- 8 is Grade Group 4
- 9 or 10 falls into Grade Group 5 – the most aggressive group
What Do These Numbers Mean for Prostate Cancer Patients?
Doctors take the Gleason Score, the Grade Group, the stage of the cancer and the PSA level to determine how aggressive a cancer is and the best treatment option for a patient, according to ZERO Prostate Cancer.
Then it’s up to a patient to take this information and make an informed decision on how to proceed.
CyberKnife Treatment for Prostate Cancer
The experts at the CyberKnife Center of Miami are here to help you make the best informed decision and treatment choice for your particular level of cancer. They can look at your scores and determine what treatment option gives you the best chance for an excellent outcome. Call them for a second opinion, which is always a good idea.
CyberKnife Miami offers state-of-the-art radiation treatment for prostate cancer called stereotactic body radiation therapy or SBRT.
Here are the advantages:
- It’s noninvasive.
- There is no risk of infection, and no long periods of downtime like with surgery.
- CyberKnife’s treatments can be done in five therapy sessions over 10 days instead of 42 over three months with other types of radiation treatments.
- The CyberKnife radiation beams, which target and destroy the tumor, are exceedingly precise so there is a reduced risk of side effects including impotence and incontinence.
CyberKnife Treatment Miami
At CyberKnife Miami, we have successfully treated hundreds of prostate cancer patients from across the country and right here in South Florida with excellent results.
If you are diagnosed with prostate cancer, call CyberKnife Miami for a consultation. Bring us your Gleason Score, Grade Group, PSA level and stage of cancer, and we’ll help you make sense of it all.
If you would like to find out more about prostate cancer treatment with CyberKnife, call us at 305-279-2900 or go to our prostate cancer website now for more information.